© 2025 International Health Terminology Standards Development Organisation. All rights reserved. SNOMED CT® was originally created by the College of American Pathologists.
This document forms part of the SNOMED CT® Belgium Extension release distributed by International Health Terminology Standards Development Organisation, trading as SNOMED International, and is subject to the SNOMED CT® Affiliate License, details of which may be found at https://www.snomed.org/snomed-ct/get-snomed
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Page At A Glance
1. Introduction
SNOMED CT terminology provides a common language that enables a consistent way of indexing, storing, retrieving, and aggregating clinical data across specialties and sites of care.
The International Health Terminology Standards Development organization (IHTSDO®), trading as SNOMED International, maintains the SNOMED CT technical design, the content architecture, the SNOMED CT content (includes the concepts table, the descriptions table, the relationships table, a history table, and ICD mappings), and related technical documentation.
We kindly encourage all Belgian users to submit their feedback on the content of the Belgian Edition through the NRC's Request Management Portal.
2. Background
This document provides a summarized description of the content changes included in the June 2025 Production release of the SNOMED Clinical Terms® Managed Service Belgium Edition package.
It also includes technical notes detailing the potential known issues. These are content or technical issues where the root cause is understood, and the fix has been discussed and agreed, but has yet to be implemented.
2.1 Scope
This document is written for the purpose described above and is not intended to provide details of the technical specifications for SNOMED CT or encompass every change made during the release.
3. Content Development Activity
3.1. Summary
This extension contains concepts, relationships and reference sets with their Dutch, French and German translations.
3.2 New and Updated Content
New Belgian content in this release
Concepts
No Belgian concepts have been created or inactivated in this release.
New translated content
General Practitioner language reference sets: the following table contains the total number of translations included in the GP language reference set:
|
|
Preferred |
Acceptable |
Total |
|
DUTCH |
11685 |
6173 |
17858 |
|
FRENCH |
10728 |
5190 |
15918 |
|
TOTAL |
22413 | 11363 | 33776 |
New translations have been introduced to the three national language reference sets, both for concepts that had not been yet translated and for concepts that already contained translations. Some existing translations were inactivated or updated. The following table contains the total number of currently active translations available in the present version of the Belgian language reference sets:
|
|
Preferred |
Acceptable |
Total |
|
DUTCH |
308391 |
326938 |
635329 |
|
FRENCH |
214808 |
131555 |
346363 |
|
GERMAN |
41796 |
13458 |
55254 |
|
TOTAL |
564995 | 471951 | 1036946 |
Summary of records changed in all files
| File Content | File Name | New | Changed | Inactivated | Reactivated | New Inactive | Changed Inactive | Total |
| Association files (All Refsets) | der2_cRefset_AssociationReferenceSnapshot_BE1000172.txt [ALL REFSETS] | 63 | 0 | 0 | 0 | 0 | 0 | 63 |
| AttributeValue files | der2_cRefset_AttributeValueSnapshot_BE1000172.txt | 786 | 0 | 1 | 1 | 0 | 0 | 788 |
| Language files (DE) | der2_cRefset_LanguageSnapshot-de_BE1000172.txt | 0 | 1 | 0 | 0 | 0 | 0 | 1 |
| Language files (EN) | der2_cRefset_LanguageSnapshot-en_BE1000172.txt | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Language (FR) context specific GP Refset | der2_cRefset_LanguageSnapshot-fr-be-gp_BE1000172.txt | 0 | 1 | 32 | 0 | 0 | 0 | 33 |
| Language files (FR) | der2_cRefset_LanguageSnapshot-fr_BE1000172.txt | 2421 | 154 | 570 | 3 | 0 | 0 | 3148 |
| Language (NL) context specific GP Refset | der2_cRefset_LanguageSnapshot-nl-be-gp_BE1000172.txt | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Language files (NL) | der2_cRefset_LanguageSnapshot-nl_BE1000172.txt | 679 | 5 | 24 | 0 | 0 | 0 | 708 |
| Concepts | sct2_Concept_Snapshot_BE1000172.txt | 0 | 1 | 0 | 0 | 0 | 0 | 1 |
| Description files (DE) | sct2_Description_Snapshot-de_BE1000172.txt | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Description files (EN) | sct2_Description_Snapshot-en_BE1000172.txt | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Description files (FR) | sct2_Description_Snapshot-fr_BE1000172.txt | 2410 | 13 | 559 | 1 | 0 | 1 | 2984 |
| Description files (NL) | sct2_Description_Snapshot-nl_BE1000172.txt | 677 | 0 | 20 | 0 | 0 | 0 | 697 |
| Relationship Concrete files | sct2_RelationshipConcreteValues_Snapshot_BE1000172.txt | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Inferred Relationship files | sct2_Relationship_Snapshot_BE1000172.txt | 6 | 0 | 0 | 0 | 6 | 0 | 12 |
| OWLExpression files | sct2_sRefset_OWLExpressionSnapshot_BE1000172.txt | 0 | 1 | 0 | 0 | 0 | 0 | 1 |
| Subset For Nursing In Patient Health Records Simple Refset | der2_Refset_100941000172101SimpleRefsetSnapshot_BE1000172.txt | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Subset For Nephrology In Patient Health Records Simple Refset | der2_Refset_100951000172104SimpleRefsetSnapshot_BE1000172.txt | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Subset For Pulmonology In Patient Health Records Simple Refset | der2_Refset_100961000172102SimpleRefsetSnapshot_BE1000172.txt | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Subset For Neonatology In Patient Health Records Simple Refset | der2_Refset_100971000172106SimpleRefsetSnapshot_BE1000172.txt | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Subset For Rheumatology In Patient Health Records Simple Refset | der2_Refset_100981000172109SimpleRefsetSnapshot_BE1000172.txt | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Subset For Intensive Care In Patient Health Records Simple Refset | der2_Refset_130971000172101SimpleRefsetSnapshot_BE1000172.txt | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Subset For Infectious Diseases In Patient Health Records Simple Refset | der2_Refset_130981000172103SimpleRefsetSnapshot_BE1000172.txt | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Subset For Hematology In Patient Health Records Simple Refset | der2_Refset_130991000172100SimpleRefsetSnapshot_BE1000172.txt | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Subset For Cardiology In Patient Health Records Simple Refset | der2_Refset_131001000172104SimpleRefsetSnapshot_BE1000172.txt | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Belgian subset for medical problems in patient health records refset | der2_Refset_40811000172108SimpleRefsetSnapshot_BE1000172.txt | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Belgian subset for Vaccination Simple Refset | der2_Refset_50831000172102SimpleRefsetSnapshot_BE1000172.txt | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Belgian subset for Allergy Intolerance Causative Agent Drug Simple Refset | der2_Refset_50841000172109SimpleRefsetSnapshot_BE1000172.txt | 7 | 0 | 8 | 0 | 0 | 0 | 15 |
| Belgian subset for Allergy Intolerance Causative Agent Non-Drug Simple Refset | der2_Refset_50851000172106SimpleRefsetSnapshot_BE1000172.txt | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Belgian subset for Allergy Intolerance Manifestation Simple Refset files | der2_Refset_50861000172108SimpleRefsetSnapshot_BE1000172.txt | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Belgian simple reference set for translated edible substances | der2_Refset_541000172109SimpleRefsetSnapshot_BE1000172.txt | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Belgian simple reference set for translated plant materials | der2_Refset_551000172106SimpleRefsetSnapshot_BE1000172.txt | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Belgian simple reference set for translated animal materials | der2_Refset_561000172108SimpleRefsetSnapshot_BE1000172.txt | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Belgian GP Subset | der2_Refset_721000172106SimpleRefsetSnapshot_BE1000172.txt | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Refset Descriptor files | der2_cciRefset_RefsetDescriptorSnapshot_BE1000172.txt | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Extended Map files (containing the new BE ICD-10 map content) | der2_iisssccRefset_ExtendedMapSnapshot_BE1000172.txt | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Identifier file | sct2_Identifier_Snapshot_BE1000172.txt | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
4. SNOMED CT derived products
4.1. Reference sets
The release currently contains reference sets that serve one of the following 2 purposes :
- Reference sets to support the implementation of SNOMED CT in eHR software for clinical data entry/capture. These reference sets have a six-monthly release cycle.
- Reference sets to support data interoperability (mainly subsets representing value lists of BE FHIR profiles required by the Care Sets). These reference sets have a monthly release cycle.
A new version of a reference set is only published when there is a change compared to the previous version. Reference sets that do not require an update (meaning having no delta) are not republished despite their release cycle.
Here is a summary of the different existing refsets and their purpose:
|
Purpose |
Subset |
SCTID |
Content |
|
Clinical data entry |
Belgian subset for medical problems in patient health records refset |
40811000172108 |
Common disorders, findings and procedures found in general patient records. |
|
Clinical data entry |
Subset For Nursing In Patient Health Records Simple Refset |
100941000172101 |
Common disorders, findings and procedures registered by nurses. |
|
Clinical data entry |
Subset For Neonatology In Patient Health Records Simple Refset |
100971000172106 |
Common disorders and findings found in newborns. |
|
Clinical data entry |
Subset For Pulmonology In Patient Health Records Simple Refset |
100961000172102 |
Common respiratory disorders and findings. |
|
Clinical data entry |
Subset For Rheumatology In Patient Health Records Simple Refset |
100981000172109 |
Common rheumatic disorders and findings. |
|
Clinical data entry |
Subset For Nephrology In Patient Health Records Simple Refset |
100951000172104 |
Common kidney-related disorders and findings. |
|
Clinical data entry |
Subset For Cardiology In Patient Health Records Simple Refset |
131001000172104 |
Common cardiovascular disorders and findings. |
|
Clinical data entry |
Subset For Hematology In Patient Health Records Simple Refset |
130991000172100 |
Common blood disorders and symptoms. |
|
Clinical data entry |
Subset For Infectious Diseases In Patient Health Records Simple Refset |
130981000172103 |
Common infectious diseases caused by different pathogens. |
|
Clinical data entry |
Subset For Intensive Care In Patient Health Records Simple Refset |
130971000172101 |
Common disorders and findings diagnosed in patients in intensive care. |
|
Clinical data entry |
Belgian GP Subset |
721000172106 |
Common disorders, findings and procedures encountered by general practitioners in Belgium. This refset originated from a map between 3BT (Bilingual Biclassified Belgian Thesaurus) and SNOMED CT and has been enhanced thereafter. |
|
Data interoperability (FHIR ValueSet) |
Belgian subset for Allergy Intolerance Causative Agent Non-Drug Simple Refset |
50851000172106 |
Common non-drug substances that cause allergies or intolerances. |
|
Data interoperability (FHIR ValueSet) |
Belgian subset for Allergy Intolerance Manifestation Simple Refset files |
50861000172108 |
Common manifestations of allergies or intolerances. Monthly release cycle. |
|
Data interoperability (FHIR ValueSet) |
Belgian subset for Vaccination Simple Refset |
50831000172102 |
Common vaccine products used in Belgium. Monthly release cycle. |
|
Data interoperability (FHIR ValueSet) |
Belgian subset for Allergy Intolerance Causative Agent Drug Simple Refset |
50841000172109 |
Common drugs that cause allergies or intolerances. Monthly release cycle. |
4.1.1. New Reference sets
No new reference sets have been added to this release package.
4.1.2. Changed Reference sets
The following reference sets were updated:
- 50841000172109 Belgian subset for AllergyIntolerance, causative agent, drug EN
5. Technical notes
5.1. Known Issues
Known Issues are content or technical issues where the root cause is understood, and the resolution has been discussed and agreed but has yet to be implemented. This can be due to a number of reasons, from lack of capacity within the current editing cycle, to the risk of impact to the stability of SNOMED CT if the fix were to be deployed at that stage in the Product lifecycle.
For the SNOMED CT Managed Service - Belgium Extension Release, the following Known Issues were identified, and agreed to be resolved in the next editing cycle:
| Key | Summary | Description | P |
|---|
5.2. Technical notes
5.2.1. Notice of changes to the Belgium Edition Release Schedule
As you may already know SNOMED International has transitioned to a monthly delivery schedule for the International Edition of SNOMED CT. The move towards more frequent releases of SNOMED CT has several benefits, including:
- Inclusion of suggested changes in a shorter timeframe.
- Better interoperability, as a result of entities being able to consume release content that is more aligned with other organizations.
- The prevention of circular dependencies that occur in longer projects, due to the move towards smaller, more manageable authoring projects.
- More automated validation services, as a result of the inherent removal of the Alpha/Beta stages in the Release cycle.
Whilst most users will continue unaffected (as they can simply continue to download the releases every 6 months as always), this transition will necessarily involve a few changes to process/packages:
- Delta files have been removed from both International and Managed Service release packages, including the Belgium Extension. A Delta Generation service will be provided for those who need it. The Delta Generation Tool allows users to create their own Delta between two fixed release dates - you can find it here:
- The ICD-O/ICD-10 Maps will continue to be published in each Monthly International Edition release package (in line with that month's content) for the foreseeable future, unless we experience issues with the new process in Production, and they need to be removed at a later date.
The Belgian edition of SNOMED CT is also released monthly on the 15th of each month, except for January and August. The first monthly Belgian edition was published in November 2024.
5.2.2. Notice of changes to the BE Edition Release package
In line with the refined implementation of Annotations, we are updating all Extensions in order to align them with the updated version of the refsets in the International Edition Release package (which were first published in June 2024).
- The languageCode field was specified as the two characters of ISO|-639-1 code for the language of the annotation text. The change includes support for specifying dialect when it is applicable by adhering to RFC 5646, which allows the combination of two characters of ISO 639-1 code and two uppercase letters of country code (ISO 3166) separated by a hyphen. The changes apply to both the Member Annotations String Value Reference Set + Component Annotation String Value reference set:
- The column "languageCode" has therefore been changed to "languageDialectCode".
- Component Annotations (1292992004)
- OLD: id effectiveTime active moduleId refsetId referencedComponentId languageCode typeId value
- NEW: id effectiveTime active moduleId refsetId referencedComponentId languageDialectCode typeId value
- Member Annotations (1292995002)
- OLD: id effectiveTime active moduleId refsetId referencedComponentId referencedMemberId languageCode typeId value
- NEW: id effectiveTime active moduleId refsetId referencedComponentId referencedMemberId languageDialectCode typeId value
- Component Annotations (1292992004)
- The column "languageCode" has therefore been changed to "languageDialectCode".
Approvals
|
Final Version |
Date |
Approver |
Comments |
|---|---|---|---|
| 1.0 |
|
Pedro Diaz Lammertyn | Approved |
| 1.0 |
|
David Op de Beeck |
Approved |
Download .pdf here:
Draft Amendment History
|
Version |
Date |
Editor |
Comments |
|---|---|---|---|
|
0.1 |
|
Andrew Atkinson | Initial draft created |
|
0.2 |
|
Leong Hui Wong | Draft updated |
| 1.0 |
|
Pedro Diaz Lammertyn | Final updates |